10220 SW GREENBURG ROAD-6 o
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10220 SW GREENBURG RD
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C!TY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 —
BUP _
_ Cate Requested ;;V/SIM AM� PM _ BLD
Location 0 Z_2 Suite MEC
Contact Person �!_{1�S Ph �3 l� -l��t��� _ PLM
Contractor _ Ph SWR _
BUILDING 1 snanUOwner EL 1
RetRining Wall ELR
Footing Access.
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab L 0)
Post&Beam SIT
IExt Sheath/Shear —
Int Sheath/Shear
raming
insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Root
Misc
Final — — �-- --�
PASS PART FAIL
PLUMBING r
Post 8 Beam
Under Slab if
Top Out
Water Service
Sanitary Sewer
Rain,nrains
Final --
PASS PART FAIL _—
MECHANICAL
Pcst& Beam - --- ---—--- -.. —— _
Rough In
Gas Line ---- - _ —
Smoke Dampers
Final — —
PASS PART FAIL
Service _
Rough In — ` —
UG/Slab
Low Vollege
Fie Alalm —_ —
&PAOS5SPART FAIL
Backfill/Grading -- — —-- ——
Sanitary Sewer
Storm Drain I ]Reinspection fee of$ required before next inspection. Pay at City Hall, 13.4
28,;SW Halt Blvd
Catch Basin
Fare Supply Line C )Please call for reinspection RE: C I Unable to Inspect-no access
ADA
Approach/Sidewalk •
a A
Other Date Inspector_ Ola-9 Ext
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.
CITY OF TIG.ARD SUiLDING INSPECTION DIVISION MST G
24-Hour Inspection Line: 639- 175 Business Lin639-
::�J71 ,�5B&i
U
_
__Date Requested �- n AM_��PM '�.00D'y00
I
3 F�`
Location U .� Suui�te/ MEC
-- V + l�CN La ' Ph _°�1..�' C � PLM
Contact Person
Contractor _ ^ Ph SWR
UILDI Tenant/Ownerk. 'r'I,�1 'Jr EL.0 _
Retaining Wall _
Footing Access: FPS
Foundation
Fig Drain SGN
Crawl Drain Inspection Notes: J-
Slab -_— -- —- SIT --_7
Post&Beam
Ext Sheath/Shear -- -'
Int Sheath/Shear
Framing ------ - -
Int,ulation
Drywall Nailing _ _._. — ---- --- -- - --�
Firewall_
Firms
Susp'd Ceiling ---------- --- — -- - --
Roof
mis
ASS' PART FAIL -- ___----
PLUMBING -----_-.-__
Post&Beam
Under Slab ._..-
Top Out
Water Service - --- ----
Sanitary Sewer -
Rain Drains --- — - --
Final
PASS PART FAIL -
MECHANICAL
Post&Beam - - - ---- - -- -
Rough In
Ras Line I - ----
�
r
Smoke Dampers -
Final ---
PASS PART-FAIL
ELECTRICAL �-
Service _ -- - --- -
Rough In
UG/Slab -
Low Voltage
Fire Alarm - - -- - -
Final
PASS PART FAIL -- --SITE _
Backfill/Grading - —
Sanitary Sewer
Storm Drain [ I Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Calt;h Basin [ Please call for reinspection RE:_. [ ]Unable to Inspect-no arrass
Fire Supply Line
ADAz "�
Y
Approach/Sidewalk Date � D Inspector f /� Ext
Other --
Final
PASS PART FAIL 00 NOT REMOVE this Inspection record from the job site.
w
CITYOF 'TIGARD � BUILDING PERMIT _
PERMIT#: BUP1999-00531
DEVELOPMENT SERVICES DATE ISSUED: 12/21/1999
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4171
SITE ADDRESS: 10220 SW GREENBURG RD 5TH FLOOR PARCEL: 1S135Ag-01004
SUBDIV1.3ION: MRRlM0R)LN TOWN OF METZGER ZONING: C-P
BLOCK: LOT: JURISDICTION: I1G
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTiO_N
CLASS OF WORK: ALT FIRST: _ A sf N: S: E: W:
TYPE OF USE: COM SECOND: sf _ PROJECT OPENINGS?
TYPE OF CONST: 2FR 42 i sf N: S: E: W:
OCCUPANCY GRP: B TOTAL AREA: sf ROOF CONST FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT. ft GARAGE: sf OCCU SEP, RATED:
BSMT?: MEZZ?: REQD SETBACKS_ _ _ REQUIRE=D
FLOOR LOAD: psi LEFT: tt RGHT: T ft FIR SPKL: Y SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIP .LRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKir-..G:
VALUE: $ 20,000.00
Remarks: TI Looped Corridor. No change in occupant load.
Owner: Contractor:
KNICKERBOCKER PROP, INC XXIV PIONEER CONSTRIJUTION SERVICE
BY NORRIS, BEGGS + SIMPSON PO BOX 68304
10300 SW GREENBURG RD STE 200 MILWAUKIE,OR 972.68
P9PTI.AND, OR 97223 Phone: 652-1050 Q ` i
one: ORIGINAL..
Reg#: uc oo�zesor�
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Framing Insp
PRMT KJP 12/21/1995 $216.50 99-320573 Gyp Board Insn
Susp Coiing Insp
P1_CK. KJP 12!21/1995 $140.73 99.320573 Final Inspection
5PCT KJP 12/21/199 $17.32 99-320573
FIRE KJP 12/21/1995 $86.60 99-320573
Total $461.15 - -
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specia;ty Codes
and all other applicable law. All work will be done in accordance with approved plans. This pei :iit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the riles adopted by the Oregon Utility Notificatior Center. Those rules are set forth in OAR
952-001-0010 through OAF; 952-001-1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 1987.
Pem;itee )j' ZA,
Signati.rre:
Is:;ued By: ��L 7�r1-.•��
Call 639-4175 by 7 p m. for an Inspection the next business day
r r OF TIGARD Commercial Building Permit Application Recd By_
13125 GW HALL BLVD. Tenant Improvement Date Date to
TIGARD, OR 97223
Dale to DST r
(503) 639-4171 �V -L AW
Permit# .�t 1 k� 0053
Print or Type Related SWR#
Incomplete or illegible applications will not be accepted Called_.__,
----- Name of Development/Project - Existing Building New Building
Job Linrolh Center �^ ------
Address Street Address Suite --- Building 7�i ee L j co�►, �.
(02?lD SW G✓eenburo )Zd. F f+-)1 CUrr f c, Data
1 o o v
eldy# - clty/state Ziy Existing Use of Building or Property:
THPt E
LINCOLN PG Iand,G�✓r?�on "i�2'L�-�
Name �I
Property Kvtickev6oc.ker fr'oFerties,In g.= Proposed Use of Building or Property: �
Owner Mailing Address Suite CST CE�
(o3or) ,;N!Greenb�i9 N . ?e f? No. Of Stories: -
City/State Zip Phone (is) S
('or`fland Sq Ft. Of Project: ^----''
Occupant Name -- '�n•c' ____ i
Occupancy Class(es)
Name r
Contractor Con-EUu0�ic*i Type(s)of Construction
_ f
Prior to permit Mailing Address Suite
issuance,a copy nX �g3c�`iWil this project have a Fire Suppression System?
of all licenses
NO
are required it City/Seale Zip Phone YeS [) [�
expired In C o T Americans with Disabilities Act(ADA)
database M�Iv`la��k�e ,O� 9�?.'L'L � �Z ��� _ Valuation X 25% = $ Participation
Oregon Const.Cont Board Lic.# Exp.Date Complete Ac_c_essibilit Form
Z
�' �fo89 0900 Project � $
- - -^ Name Valuation 2'�i _
Architect G(S[� Arcl,, c'ts, In,. Pians Required: See Matrix for number of sets to submit
/ Mailing Address Suite on back
'j 2G' SW Jr k le n u e g-OOC-
City/State zip
Phone I hereby acknowledge that I have read this application,that the information
)crtIamd ,C-'-. �)72r),i X24 c) 5G given Is correct,that I am the owner or authorized agent of the owner,and
Engineer Name
-- — that plans submitted are in compliance with Oregon S!?mte Laws
Signature of Owner/Agent Date
Mailing Addressy TSuite t YL ,�C-L l Z,/2//99
CgnMct Person Name Phone
Gity/State Zip Phone
-� FOR OFFICE USE ONLY
Indicate type of work: New O Addition O Demolition O Map/TL# Land Use:
Struryure O Foundation Only O Alteration
19 Repair O _ Other O Notes:
Description of work:
�rt+°thsror, of exist," Corr„ACv +0 -�rh, TIF
Loop CrorriJc rrr
Note: Site Nork Permit Application must precede or accompany Hulldln7
Permit Application
I\COMNEWTI.DOC (DST) 5/98
COMMERCIAL PLAN SUBMITTAL
REQUIREMENT MATRIX
Plan Review is dependent upon submittal of BOTH plans AND a COMPLETED
application. For an electrical suhrnittpl, the application must contain the
signature of the supervising electrician Wore plan review will be conducted.
After plain review approval, Plans Examiner will contact the applicant to request
additional plan sets for distribution purposes. (Copy For Contractor, 0,ity,
Washington County, Tualatin Valley Fire & Rescue)
�- Total # of
TYPE OF SUBMI1-TAL Plans KEY:
Sub_mitt_ed
S (Private) 1 S = Site Work
B (New or Add) 1 B = Building
F (New or Add or Alt) _ 3 F = Fire Protection System
-a-(New or Add or Alt) 1 M = Mechanical
B & M (New or Add) 1 P Plumbing
P (New, ,add, or Alt) 2 E = Electrical
B & M & P (New or Add) _ 2 New = New Building
E (New, Add, or Alt) ` 2 Add = Addition
B & F & ki & P & E 3 Alt = Alternation to Existing
(New_, Add) _ Building
*B or B &._M {Alt) 1
(Alt) 3 .�.
*B & M & P & E(Alt) � 3
*B & M & P & E & F(Alt)—
NOTES:
*Shaded areas designate ALT submittals only.
I tdstslforrnskmatrxcom doc 10/30/98
OVER-THE-COUNTER (OTC) PERMIT PLAN REVIEW
COMMERCIAL (STRUCTURAL_) BUILDING PERMIT CHECKLIST
DESCRIPTION OF PROJECT: i :ne4 �_.0022A 1�21 _
CLASS OF WORK: FLOOR AREAS. Z� EXTERIOR WALL CONSTRUCTION
TfPE OF USE: FIRST SQ. FT. N. S:_ E: W.
f
+',,E OF
CONSTR: l� F t SECOND SQ. FT. PROTECT OPENINGS?:
OCCUPANCY GRP: ( T,HIRD SQ. FT. N: S: E: W:
OCCUPANCY LOAD: TOTAL SQ, FT. ROOF CONSTR: FIRE RET:
STOR: HT: FT: BSMNT: SQ. FT. AREA SEP. RATED:
BSMNT?: MEZZ?: GARAGE: SQ. FT. OCCU.SEP.RATED:
FIRE I IRE SMOKE HANDICAP
SPRINKLER: ALARM: DETECTOR: ACCESS:
COMMERCIAL INSPECTION ACTIONS FEE MENU
Foot/Found Post/Beam $ ,' Permit Fee
_ Masonry Framing' $ Plan Review
1 '
Insulation Shear Wall $ 1~� 8% State Surcharge
Firewall Gyp Board ' $ L FLS Plan Review
Suspended Ceiling _ Sprinkler Rough-in $ Add] Permit Fee
Sprinkler Final Fire Alarm $ Add'I FLS Pin
Smoke Detector _ Approach/Sidewalk $ Inspection
Miscellaneous Finel $ MIS Fee
FOR OFFICE USE O1 LY:
TYPE OS USE OPTIONS(COM=commercial; CMS=commercial manufactured structure)
CLASS OF WORK OPTIONS FOR ALL PERMITS(NEW=new;Add=addition;ALT=alteration;ACS=accessory;FND-foundation;
OrR=other;DEM=demolition;REP--repair;FPS=fire protection system,NOTE: USE OTR FOR FENCES, RETAINING
WALLS, DETACHED DECKS, SIGNS, AWNINGS,CANOPIES)
I:\ovrcntr2 doc (DST) 9/99
ELECTRICAL PERMIT
CITY OF TIGARD .
PERMIT#: ELC1999-00758
DEVELOPMENT SERVICES DATE ISSUED: 12/27/199L,
13125 SW Hall Blvd., Tiqard, OR 97223 (503) 639-4.71 PARCEL: 1S135AB-01004
ADDRESS: 10220 SW GREENBURG RU 5TH FLOOR
SUBDIVISION: W®R1l39RLN - TOWN C17 METZGER ZONING: C-P
BI-(';(;K: LOT : JUI: SDICTION: TIG
Piu:ect Description: First branch circuit
RESIDENTIAL UNIT_ __ TEMP SRVC!FEEDFR_S _ MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 400 amp: SIC NICUT LINE LTG:
LIMITED ENERGY. 4.71 600 amp: SIrjNAI_/PANEL:
MANF HMI SVC/ FQ�i: 601+amps - 1000 volt!-: MINOR LABEL (10):
SFRVICEiFEEDER BRANCH CIRCUITS _ ADD'L INSPECTIONS
200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
400 amp: Ist W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp. _ PLAN REVIEW SECTION _
1000+ amp/volt: >=4 RES UNITS: i > 600 VOLT NOMINAL:
Reconnect only: 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
KNICKERBOCKER I ROP, INC XXIV CHRISTENSON ELECTRIC INC
BY NORRIS, BEGGS + SIMPSON 111 SW COLUMBIA
103u0 SW GREF_NPURC, RD SLE 200 STE 480
PORTLAND, OR 97223 PORI-LAND. OR 97201
Phone: Phone: 241-4812
Reg#: LIC 000458
SUP 3289S
PL.M 2468S
ELE 26-34C
FEES v_ _ Required Inspections
Type By Date Alnount Receipt v_ Elect'I Service
PRMT BON 12/ 1, '99r $37.50 99-320663 Elect'I Final
5PCT BON 12/27/199 $3.00 99-120663
Total — $40.50 ORIGINAL
This Permit is issued subject to the regulations contained in the Tigard Municipal Code. State or OR Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans Thi.;permit will expire if work is not started within 180 days of issuance,or if work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules are set forth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503)
2,16.1987
PERMITTEE'S SIGNATURE L,., l �'t /d(o� ___ ISSUED BY:
—Ic1—
_ON_NER INSTALLATION ONLY
The installation is being made on property I owr) which is riot intended for sale, lease, or rent.
OWNER'S SIGNiaTURE: _- DATE:
CONTRACTOR INSTALLATION ONLY _
SIGNATURE OF SUPR. ELEC'N: _ �[11LC>(x. �L' h I��t L DATE:
LICENSE NO: _ — _—
Call 639-4175 5y 7:00pm for an inspection the next business day
CITY OF TIGARD }..a-`"EI lectricai Permit Application Plan Check# _
13125 SW HALL EIL.VD. Recd By ►�-
TIGARD OR 97222 DEC 2 7 1999 Date Recd
Date to P.E.
Phone(503)639-4171, x304
r`)MMUNITII DEVELOI'MENI Date to DST
Inspection (503)639-4175 Print of Type Permit# e7z I
Fax(503)598-1960 Incomplete or illegible will not be accepted Called _
1. .lob Addres3FURRIS,BEGC,S,SIMPSON PROPERTY M C> T Complete Fee Schedule Below:
Name of Development LINCOLN CENTRE Number of Inspections per permit allowed
Name(or name of business) LINCOLN 11I Service included: Items Cost Sunt
Address10220 SW GREENBURG RD 5TH FL LOOP CORR IA Ida. Residential-per nit
City/State/Zip PORTLAND OR1000 sq.ft.Each additional less $ 117.75
sq.N or
Commercial[3KResidential ❑ Limited
thereof $ 26.25 l
mited Energy $ 80.00
QUESTIONS?CONTACT ROSS CROSBY 245-1965 Each Manufd dome or Modular —�-
29. Contractor installation only: Dwelling 5 irvlce or Feeder $ 72.75 z
(Prior to permit issuance,applicants must provide contractor license 4b.Services or Feeders
Information for COT data base). installation,alteration,or relocation
Electrical Contractor ChR1STENSON ELECTRIC, INC 200 amps or less $ 64.25 2
Address 11 1 SW COLUMBIA,SUITE4R0 201 amps to 400 amps $ 85.502.
Cit PORTLAND State OR Zi 97201-5886 401 amps to 600 amps $ 128.50 2
Y --- p 601 amps to 1000 amps $ 192.50 2
Phone No. 503 241-4812 — ` _ over 1000 amps or volts _ $ 363.75 2
Job No. 62-09450 Reconnect only $ 53.50 2
Elec. Cont. Lice.No. 26-34C Exp,Date 10/00 4c.Temporary Services or Feeders
OR State CCB Reg.No. 458 Exp.Date 5/03 Installation,alteration,or relocation
COT Business Tax or Metro No. 5246 Exp.Date 12tf10 200 amps or less $ 53.50 2
-- —' 201 amps to 400 amps $ 80.25 2
401 amps to 600 amps T 107.00 2
Signature of SupfOver 600 amps to 1000 volts,
see•'b"above.
License No.
_8 7 3 S Exp.Date 10/01
Phone No. 241-4812 4d.Branch Circuits
--- -- -- New,alteration or extension per panel
a)The fee for branch cirruits
2b. For owner installations: with purchase of service or
feeder lee.
Print Owner's Name Each branch circuit $ 5.35
-- - b)The fee for branch circuits
Address without purchase of service
City - State -Zip__ or feeder fee.
Phone NoFirst branch circuit 1 $ 37.50 37.50
— Each additional branch circuit __ $ 5 35 _
The installation is being made on property I own which is not 4e.Miscellaneous _
intended for sale,lease or rent. (Service or feeder not incl ided)
Each pump or irrigation circle $ 42 75 _
Owner's Signature _ - F.ach sign or outline lighting _ _ $ 4275
Signal circuit(s)or a limited energy
if required):* panel,alteels(1Uen or extension $ 6000
3. Plan Review section
Minor labels(10) $ 10700
Please check appropriate Item and enter fee In section 5B. 0.Each additional Inspection over
_4 or more residential units in one structure the allowable In any of the above
Service and feeder 225 amps or more Per inspectinn _-_- $ 5000 `
Per hour T 5000
System over 600 volts nominal In Plant — $ 5900
Classified area or structure containing 3peaial occupancy as
described in N E C Chapter 5 JF. Fees:
Sa Enter total of above fees $ 37,50
+ Submit 2 sets of plans with application where any of the above apply. 5%Surcharge(05 x tots;fees) q $ _
Not required for temporary construction s)tvices. Subtotal 8° $ I n-Sn
5b.Enter 25%of line am for
NOTICE Plan Review if requir+d(Sec 3) $ _
PERMITS BECOME VOID IF WORK CcR rONSTRUCTION AUTHORIZED Subtotal $ 40 SO
IS NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR
WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS ❑ Trust Account#
AT ANY TIME AFTER WORK IS COMMENCED. Total balance Due $ 40.50
i ,d%IrNIbrms\cIectrIc.doc
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 �
�� C
&(BUP�IO�C?'_� j
Date Requested 2 AM _ PM
Location
Contact Person t `�� Ph 9 �� PLM -- -a-
11 k
Contractor _ t _Ph
� SWR
]LDIF• a�— Tenant/Owner �_ "� _ + \ELC
Retaining V`!all �� R -
Footing Access: �r .:--n jt -ef N �-4u E � FPS (4
Foundation
Ftg Drain --- SGN
Cravtl Drain Inspection Notes:
Slab _�.------- ---- _— ---- ------- SIT —--
Post&Beam
Ext Sheath/Shear --- — i
Int Sheath/Shear v�
Framing
Insulation
fly—aTi Nattht� 1_/G� �5t'
0 dFirewall Fire Sprinkler FireAlarmCIC?�� (J�.� ��
Susp'd Ceiling
Roof
Misc: -1/—�n —J
Fin V ►� \�%e— ` cict" V U --
A S PART FAIL 1
RING
Post&Beam
Under Slab
Top Out
Water Service I - -
Sanitary Sewer
Rain Drains
Final
PA PARI FAIL
_CHANI L
l - - -
Rough In
Cas Line
4Smo e Dampers
in
A PART FAIL -
ELECTRICAL
Service -- --- __--
Rough In
UGISIab
Low Volt.. e
Fire Alarm
Final
PASS PART FAIL
SITE –
Backfill/Grading
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ require( bQfore next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ]Please call for reinspection RE: _ [ ]Unable to inspect-no arcesp.
Fire Supply Line
ADA ,�
Z' Cj
Approach/Sidewalk Date k/\-1'/60 6v Inspector -. �EX '" ' L
Other _
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
'
CITY
��� �� ������ �3UILUIt•IG PERMIT
PERMIT #: BUP2000-00023
DEVELOPMENT SERVICES DATE ISSUED: 01/26/2000
13125 SV4 Hall Blvd.,Tigard, OR 97223 (503) 611-4171 PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 5TH FLOOR
SUBDIVISION: CQ9'MMMLN - TOWN OF METZGER ZONING: C-P
BLOCK: LOT: JULISDICTION: TIG
REISSUE: _ FLOOR AREAS EXTERIOR WALL 'CONSTRUCTION _
CLASS OF WORK: FPS !— FIRST: sf — N: —S: —E: W:
TYPE OF USE: COM SECOND: sf _ _ _PROJECT OPENINGS?_
TYPE OF CONST: sf N: - S: E: W:
OCCUPANCY GRP: TOTAL AREA: sf ROOF CONST: FIRE RFT?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT'?: MEZZ?: REQD SETBACKS _ _ REQUIRED_
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK GET:
DWELLING UNITS: FRN r: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 425.00
Remarks: Relocating six sprinkler heads in corridor
Owner: Contractor:
KNICKERBOCKER PROP, INC XXIV BASIC FIRE PROTECTION INC
BY NORRIS, BEGGS + SIMPSON 940 NE LOMBARD ST
10300 SW GREENBURG RD STE 200 PORTLAND, OR 97211
P�Pone:TLAND, OR 97223
Phone: 085-1855
Reg #: LIC 000486
�— FEES REQUIRED INSPECTIONS
Type By Date Amount ReceiptSprinkler Rough-In
PRMT� BON 01/26/200( $50.00 00-321400 Sprinkler Final
5PCT BON 01/2.6/2000 $4.00 00-321400
Total $54.00 ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR.
Specialty Codes and all other applicable law. All work will be done in accordance with approved plans.
This permit will exrire if work is not started within 180 days of issuance, or if work is suspended for more
the n '180 days. AT FENTION. 7regon law requires you to follow the rules adopted by the Oregon Utility
Notification Center. Those rulk are set forth in OAR 952--001-00'10 through OAR 952-001 -1987. YOU
may obtain a copy of these rules or direct questions to OUNC by calling (503) 246-1987.
Penritee
Signature:
Issued B y: —._—
Call 639-4115 by J p.m. for an inspection the next business day
Fire Protection Permit Application Plan checs;# _
CITY OF TIGARD Commercial or Residential Recd By (�_
1: 125 SW WALL BLVD. Date Recd
TIGARD, OR 97223 Print or Type Date to P.E.
(503) 639-4171, x. 304 Incomplete or illegible applications will not be accepted Date to DST
Pemiit# '7
Called—
I—�—Job Name of Developm9nuProject — Type of System (Complete A or B as applicable) —
Address Address r f ��'' `.t A.)Sprinkler Wet Dry
- --
Nome/ IoYtrl'� '��' '�" - ---- Standpipes
Owner Mailing Address Additional Hazard Group
City/State Zip Phone Information Densit; -- --
— Name ~ Design Area
SiZc�2'rs _
Occupant r+failing Address s� K.Factor
ay��3i/�✓C�l'lt�i�xLtGXP
City/state Zip Phone A.1) Sprinkler Project Valuation $ err
-- a`C.. C i• — -- �c 5
Contractor B.) Fire Alarm
Nam
(Sprinkler or /
Alarm Company) Mail' ddres Submittal Shall Include Battery Calculations YES(]
Prior to permit ` ?A
Issuance,a City/`''ate Zip Phone Individual Component YES❑
COPY _ Cut Sheets
of all dcenses '> Sys-_ i B 1) Fire Alarm Project Valuation $ —
are required if State Const.Cont.Board Lic.# Exp.Date
expired it)COT Poje
rct Va _luation Subtotal
database _
Name.;�*l Permit fee based on valuation $ 50.Y)
Architect Mailing address — (see c art on back)
UJI/6 Surcharge $
city/stato — Zip I P` ne FLS Plan Review 40% of Permit $
Describe work A.)New O Addition O Afteratio Repair O L -
to be done: I TOTAL $ `x 1
B) Modification to sprinkler heeds only: Plans re aired Submit three sets of plans,including a vicinity map and
1. 1"10 heads=No plans required q p g y
2. 11—Plan review required the location of the nearest hydrant.
---__ 1 hereby acknowledge that I hdve read this application,that the Informs,tion given is
Number of sprinkler heads correct,that I am the owner of authorized agent of the owner,and that plans submitted
—
Additional Description of Work: are In compliance with Oregon State laws
' -IM r� c � -� Slgns�yrs of Owner/Agent Date / —
A.)In Existing Building New Building
Building Contact PersomNaa Phone _
B.) Commercial Residential ❑ �~� `'/��`, 2-$S'/85
Data FOR OFFICE USE ONLY: _
No.of stories: �+ Plat# Map/TL.#:
Sq. Ft: ---
Notes
Occupancy Class Type of Construction
is\dsts\forrns\ftresupr.doc 712/99
CITYOF w`IGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC1999-00558
2/16/1999
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED:
PARCEL: IS135AB-
01004
SITE ADDRESS: 10220 SW GREENBURG RD 5TH FLGJR
SUBDIVISION: V0FnIbMLN TOWN OF METZGER ZONING: C-P
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: C(-".S UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: 6 BOILERS/COMPRESSORS HOODS:
_ FUEL_TYPES _ _ 0 3 HP: DOMES. INCIN:
3 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS'?: 30 - 50 HP: REPAIR UNITS:
WOQDSTOVES:
GAS PRESSURE: 50 + HP:
FURN -. 100K BTU: AIR HANDLING UNITS CLU DRYERS:
FURN >=100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Remarks: Extending return air duct through corridor A building permit for the corridor wall is required.
Owner`M _ FEES _
KNICKERBOCKER PROP, INC XXIV Type By Date Amount Receipt
BY NORPIS, BEGGS + SIMPSON PRMT KJP 12/16/19f $50.00 99-320468
10300 SW GREENBURG RD STE 200 PLCK KJP 12/16/19 $12.50 99-320468
PORTLAND, OR 9722.3 5PCT KJP 12/16,19 .$4.00 99-320468
Phone: Total $66.50
Contractor: -
NORTH PACIFIC HEATING
33700 SE DUUS RD
ESTACADA, OR 97023 REQUIRED INSPECTIONS
Mechanical Insp
Phone: Final Inspection
Reg #:I IC 00063746
N In
IGINAL
This permit is issued subject !o the regulations contained in the Tigard Municipal Code, State of Ore.
Speci�lty C odes and all other applicable laws. All work will be done in accordance with approved
This his -)errr0t will expire if work is not started within '80 days of issuance, or if work is suspended
for more thar 180 days ATTENTION: Oregon law requires yuu to follow rules adopted in the Oregon
Utility Nntific,tion Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may oblain co 1e of these rules or direct questions to DUNG by calling (503)246-9109.
Issue By, -r t .. - Permittee Signature: + /
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business
Plan Check#
CITY OF TIGARD McChanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 \ Date to P.E.
(503) 639-4171, x304 \ { �"I�C Date to DST / �_
Print or Type Permit#���q-0055r,
Incomplete or illegible applications will not be accepted Called
Nam9 of DevelopmenUProject Description —_
_ Table 1A Mechanical Code _ Qt Price Amt
Street ass
- � 1 sunup A) Permit Fee 16 00
Job dr
✓ 1) Furnace to 1"000 61 U
Address L �r .5:. i �� including ducts R vents 9.65
eldgtr Cny/state Baa S llll 2) Furnace 100,000 BTU+
including ducts&vents 12.00
Name I(or name of businiss) 3) Floor Furnace
Owner 1 _ includirin vent - 9.65
Arai rng Addres 4) Suspended heater,wall heater
or floor mounted haater _ 9.65
11. I JFAr� _-I5) Vent not included in a ppliance ermit_ 4.75
C'y/State ZIP Phone Check all that apply 'Boiler Heat Air
Ot f!A.'• For Items 6-10,see or Pump Cond Qty Price Amt
Name(or name of business) footnotes 1,2 Com
/ _ 6)Repair units
C _�'�S�IL>� _ _ _ 8.40
Occupant Mailing Aidress 7)<3HP,absrj,b unit to
C;k 100K BTU _ 9.55
ClIpSlate Zip hone8)3-15 HP,absorb unit
100k to 5001k BTU_ _ 1765
- -+£1'3'Z y) 15-30 HP,absorb -
Contractor ame f _ -
unit.5.1 mi!BTU 24.15
_.
_ 10)30-50 HP,absorb
Prior to permit Ma+ g Addressunit 1-1.75 rail BTU _ 3600
issuance,a copy -, , L.. : +1)>60HP,absorb unit>1.75 mil_BTU
of all licenses cny1stale z p Phone _ _ _ 60.15
are required ifr. 12)Air handling unit to 10,000 CFAt _ —
expired in COT Oregon Const on o L c p Exp Date ' _ 7.00
database ?3)Air handling unit 10,000 CFM r
Architect Nem' _ _ 11,85
)4)Non-portable evaporate cooler
Or Mailing Address — 7.00
15)Vent fan connected to a single duct
4.75
-CftvfSlate— zip Phone
Engineer 16)Ventilation system not included in
appliance permit -_ 7.00 _
Describe work to be done. 17)Hood served by mechanical exhaust
7.00
New O Repair O Replace with like kino Yes O No O 18)Domestic incinerators
Residential O Commercial O Modification O _ _ _ 1200
19)Commercial or industrial type incinerator
Additional information or description of work 48 25
�/ /� ��- ��' J 70) Other units, including wood stoves
�,► /G//'�DZiC{,. 4111 Q� !f,� L f ----- 7.00 !r.'
N E: For Commercial projects only,Units over 400 Ib6f, oca!ed on the 21)Gas piping one to four outlets
roof,require structural talcs prepared�ylic;ensed engineer _ 3.75
Type of fuel oil O natural gas O LPG O electric O 22)More than 4-per outlet(each) 75
1 hereby acknowledge that!have read this application,that the information Minimum Permit Fee$50.00 SUBTOTAL o
given is correct,that I am the owner or authorized agent of _,_ ____ 8%SURCHARGE
PLAN REVIEW 25%OF SUBTOTAL
the owner,tha,plans submitted are in compliance with Oregon State laws Required for ALL commercial permits only
Signature of Owner/Agent Date ^^ TOTAL
o
Z' C 6Y
V _ Other Inspections and Fees-
Contat:t arson Name Phone
1 Inspections outside of normal busutess hours(minimum charge-two hours) $50 00 per hour
2 Inspeclions to-which no fen Is specifically indicated (minimum charge-half hour)
' $50 00perhoui
Foonotes for commercial pr only: 3 Additional plan review required by changes additions or revisions to plans(minimum
1. Provide full schematic of a ittg and proposed gas line and pressure charge-one-half Dour)$50 00 per hour
2 Provide drawings to scale showing existing and proposed mechanical 'State Cootrectr.Boiler Certification requited
units "Residential AX requires site plan showing placement of unit
I\rnechperm doc rev 1111199
OVER-THE-COUNTER (OTC) PERMIT
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Desoription of Project:
V 11
Class of Work- ^,�� Floor Furnace: Evap Coolers:
Type of Use: __ oil- _ _ Unit Heaters: _-_ Vent Fans:
Occupancy Grp Vents w/o Appi: Vent Systems:
Stories: _ X Boilers/Cornprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
3 - 15 HP, Wood Stoves:
Max Input: _ Btu: Air Handling Units CIO Dryer:
Fire Dampers: _<_ 10000 cfm: _ Oth Units:
Gas Pressure: H / M / L > 10000 cfm: , Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn > 100k Btu:
NOTES: _ _—_� —---------- -----��- -- — - -
COMMERCIAL INSPECTION ACTIONS FEE MENU
_ Gas Line Inspection $ tz'"d Permit Fee
Mechanical Inspection _$ / Z �� Plan Review
Cooling Unit Inspection $ L4 '�V 8% State Surcharge
Shaft Inspection $ �— Additional Permit Fee
Hood Inspection $ _ Additional Plan Review Fee
Firs Suppr Inspection $ Inspection Fee
Duct Inspectio i _$ Miscellaneous Fee
Fire Alarm Inspection
REMARKS:
Fire Damper Inspection
Miscellaneous Inspection
Fire Alarm Inspection
Final Inspection
FOR OFFICE USE ONLY:
1 YPE OF USE OPTIONS(COM=commercial;CMS=commcrcial manufactured structure)
i IHSS OF WORK OPTIO14S FOR ALL PERMITS(NEW=new;ADD=addition;ALT=alteration;ACS=acoessory;
FND=foundation;OTH=other,DEM=demolitlon;REP=repJr:FPS=fire protection system.NOTE=USE OTH FOR FENCES,RETAINING
WALL,DETACHED DECKS,SIGNS, W74INGS,CANOPIES) y
1:410/furms/otcrnech.doc 9/99
i WsWfiirms\otc-mcch doc9/99 I
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